Estimation of years lived with disability due to noncommunicable diseases and injuries using a population-representative survey.

Abstract

The Global Burden of Disease 2010 and the WHO Global Health Estimates of years lived with disability (YLDs) uses disability-weights obtained from lay health-state descriptions, which cannot fully reflect different disease manifestations, according to severity, treatment, and environment. The aim of this study was to provide population-representative YLDs of noncommunicable diseases and injuries using a prevalence-based approach, with the disability weight measured in subjects with specific diseases or injuries. We included a total of 44969 adults, who completed the EQ-5D questionnaire as participation in the Korea National Health and Nutrition Examination Survey 2007-2014. We estimated the prevalence of each of 40 conditions identified from the noncommunicable diseases and injuries in the WHO list. Modified condition-specific disability-weight was determined from the adjusted mean difference of the EQ-5D index between the condition and reference groups. Condition-specific YLDs were calculated as the condition's prevalence multiplied by the condition's disability-weight. All-cause YLDs, estimated as "number of population × (1 - mean score of EQ-5D)" were 2165 thousands in 39044 thousand adults aged ≥20. The combined YLDs for all 40 conditions accounted for 67.6% of all-cause YLDs, and were 1604, 2126, 8749, and 12847 per 100000 young (age 20-59) males, young females, old (age ≥60) males, and old females, respectively. Back pain/osteoarthritis YLDs were exceptionally large (442/40, 864/146, 2037/836, and 4644/3039 per 100000 young males, young females, old males, and old females, respectively). Back pain, osteoarthritis, depression, diabetes, periodontitis, and stroke accounted for 22.3%, 9.1%, 4.6%, 3.3%, 3.2%, and 2.9% of all-cause YLDs, respectively. In conclusion, this estimation of YLDs using prevalence rates and disability-weights measured in a population-representative survey may form the basis for population-level strategies to prevent age-related worsening of disability.